Work environment may be one of the biggest factors affecting the well-being of U.S. employees, according to research released last fall at EBN's 23rd Annual Benefits Forum & Expo.

Almost one-third (31%) of people in a poor work environment will state that they were angry most of yesterday, says John Harris, vice president, innovations and chief wellness officer, Healthways Inc.

"We're out there trying to do our thing from a wellness perspective, but if 31% of your workforce is angry, what are the chances they're going to hear your message and begin to make meaningful changes? Not very good," he told the audience of benefits professionals.

Healthways partners with polling firm Gallup to look at the well-being of the nation. Through interviews with at least 1,000 adults every day, the Gallup-Heathways Well-Being Index provides real-time measurement and daily assessment of Americans' emotional, physical and social health and well-being.

"When I talk to wellness audiences in particular, I'll ask them to tell me about their anger-management program," said Harris. "And they look at me like I'm crazy. But maybe as wellness professionals, they ought to be concerned about anger management."

And if you combine poor work environment with chronic illness, people with one to three chronic illnesses and a poor work environment are unable to perform their duties 6.6 more days per year than other employees.

Through the Well-Being Index, "we've been able to identify that for every 15 minutes that a person commutes additionally, stress builds up and sleep goes down and their anger goes up," said Harris.

"If you've got 20% of your population commuting more than 45 minutes, how you approach your organization with behavior change programs could be very different. At the very least you might have to have some specific things for them," he added.

Caterpillar Inc. has a robust physical wellness program, including a smoking cessation program, health risk assessments, disease management programs for diabetes, depression and heart disease, health promotion exams for employees at certain ages and a healthy eating program in its cafeterias.

The company, which covers 150,000 lives in the U.S., has managed to keep its medical cost increases close to 0% over the past several years with tweaks to its benefits plan design and pharmacy management.

But last year, Caterpillar decided to dig a bit deeper and go beyond just physical wellness. The company surveyed its employees worldwide to get a better sense of the overall well-being of its workforce.

"We're trying to move away from managing just the direct spend to really understanding the concept of whole health," said Michael Taylor, M.D., medical director for health promotion and disease management with Caterpillar.

In March 2010, the organization conducted an online, voluntary, anonymous survey of its white-collar workforce. The survey asked several questions, including ones about stress, how consistently employees felt they were able to use their strengths in their jobs, leadership and team effectiveness, and performance barriers.

When the survey was done in the first quarter of 2010, Caterpillar was still in heavy recession mode. The company had laid off 25,000 workers and had seen a huge drop in profitability. Not surprisingly, Caterpillar employees were found to be much more worried and stressed than the national average.

The company then correlated responses to the survey to its internal engagement score, which is determined by an annual survey. Comparing the two surveys showed there was a consistent correlation between well-being and engagement.

"Business units that struggled with a leadership issue also struggled with well-being," said Taylor. "The one business unit that had the absolute highest leadership score had the highest well-being score."

Likewise, the business units that scored high on well-being "felt better about how well our company - and their business unit - espouses its values. So, leadership and values absolutely correlate with well-being," said Taylor.

The company also found a correlation between team effectiveness and productivity and well-being.

Harris wondered if there will come a time when investors "can get a well-being score on a company to know how well its people are. If you've got two stocks that look generally equal, which would you pick - the one with a higher well-being or the one with lower well-being?"

For Caterpillar, what started in the 1990s as a health care cost-containment effort has evolved from a physical health improvement model to more of a productivity model, and this emotional health model is "sort of the next wave," said Taylor. "The data points the way that we really need to think more about the health of our employees, other than just what percentage have diabetes or heart disease."

He acknowledged that the message is not an easy one to sell. But he encourages employers to craft different wellness messages to the different internal audiences.

"We've changed our message from 'A healthy worker is good for Caterpillar, is more productive' to 'If you have healthy, productive workers, you can get more product out the door,'" he said. "The operations people, while they care about the health of employees, what they're really charged with is getting more product out the door. So we aligned the message with the specific audience."

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